Electrosurgical instrument with separate closure and cutting members

ABSTRACT

In various embodiments, a surgical instrument is provided that may comprise an end effector for performing a surgical procedure on tissue, for example. The end effector may comprise a pair of jaws, a closure beam, and a cutting member. The closure beam and the cutting member may be releasably coupled together by an interlocking member such that movement of the cutting member may cause the closure beam to also move relative to the jaws and cause the jaws to close and grip tissue, for example. The interlocking member may then unlock, allowing the cutting member to move through the gripped tissue and relative to the closure beam. Additionally, the cutting member and closure beam may be operated by a single trigger, which may be configured to provide haptic feedback to a user at various stages. Further, the jaws may be electrically energized to deliver energy and/or seal the gripped tissue.

This application is a continuation application claiming priority under35 U.S.C. §120 of U.S. patent application Ser. No. 12/841,480, entitledELECTROSURGICAL INSTRUMENT WITH SEPARATE CLOSURE AND CUTTING MEMBERS,filed on Jul. 22, 2010, the entire disclosure of which is incorporatedby reference herein.

BACKGROUND

The present disclosure is directed to medical devices and methods, and,more particularly, to electrosurgical instruments and methods forsealing and transecting tissue.

In various circumstances, a surgical instrument can be configured toapply energy to tissue in order to treat and/or destroy the tissue. Incertain circumstances, a surgical instrument can comprise one or moreelectrodes which can be positioned against and/or positioned relative tothe tissue such that electrical current can flow from one electrode,through the tissue, and to the other electrode. The surgical instrumentcan comprise an electrical input, a supply conductor electricallycoupled with the electrodes, and/or a return conductor which can beconfigured to allow current to flow from the electrical input, throughthe supply conductor, through the electrodes and the tissue, and thenthrough the return conductor to an electrical output, for example. Invarious circumstances, heat can be generated by the current flowingthrough the tissue, wherein the heat can cause one or more hemostaticseals to form within the tissue and/or between tissues. Such embodimentsmay be particularly useful for sealing blood vessels, for example. Thesurgical instrument can also comprise a cutting member that can be movedrelative to the tissue and the electrodes in order to transect thetissue.

By way of example, energy applied by a surgical instrument may be in theform of radio frequency (“RF”) energy. RF energy is a form of electricalenergy that may be in the frequency range of 300 kilohertz (kHz) to 1megahertz (MHz). In application, RF surgical instruments transmit lowfrequency radio waves through electrodes, which cause ionic agitation,or friction, increasing the temperature of the tissue. Since a sharpboundary is created between the affected tissue and that surrounding it,surgeons can operate with a high level of precision and control, withoutmuch sacrifice to the adjacent normal tissue. The low operatingtemperatures of RF energy enables surgeons to remove, shrink or sculptsoft tissue while simultaneously sealing blood vessels. RF energy worksparticularly well on connective tissue, which is primarily comprised ofcollagen and shrinks when contacted by heat.

Further, in various open and laparoscopic surgeries, it may be necessaryto coagulate, seal or fuse tissues. One means of sealing tissue reliesupon the application of electrical energy to tissue captured within anend effector of a surgical instrument in order to cause thermal effectswithin the tissue. Various mono-polar and bi-polar RF jaw structureshave been developed for such purposes. In general, the delivery of RFenergy to the captured tissue elevates the temperature of the tissueand, as a result, the energy can at least partially denature proteinswithin the tissue. Such proteins, such as collagen, for example, may bedenatured into a proteinaceous amalgam that intermixes and fuses, or“welds,” together as the proteins renature. As the treated region healsover time, this biological “weld” may be reabsorbed by the body's woundhealing process.

In certain arrangements of a bi-polar radiofrequency (RF) jaw, thesurgical instrument can comprise opposing first and second jaws, whereinthe face of each jaw can comprise an electrode. In use, the tissue canbe captured between the jaw faces such that electrical current can flowbetween the electrodes in the opposing jaws and through the tissuepositioned therebetween. Such instruments may have to seal or “weld”many types of tissues, such as anatomic structures having walls withirregular or thick fibrous content, bundles of disparate anatomicstructures, substantially thick anatomic structures, and/or tissues withthick fascia layers such as large diameter blood vessels, for example.With particular regard to sealing large diameter blood vessels, forexample, such applications may require a high strength tissue weldimmediately post-treatment.

The foregoing discussion is intended only to illustrate the presentfield and should not be taken as a disavowal of claim scope.

SUMMARY

In various embodiments, a surgical instrument is provided. In at leastone embodiment, the surgical instrument can comprise an end effectorcomprising a first jaw defining a channel, a second jaw, a closure beam,and a cutting member. In these embodiments, the first jaw and the secondjaw can be operably coupled together such that the first jaw may movebetween an open position and a closed position with respect to thesecond jaw. Additionally, in these embodiments, the closure beam can besized and configured to fit at least partially within the channel andthe closure beam can be configured to translate along the channelbetween a first position and a second position. Further, in theseembodiments, the first jaw may be at the closed position when theclosure beam is at the second position. Also, in these embodiments, thecutting member can be sized and configured to fit at least partiallywithin the channel. Moreover, the cutting member can be configured totranslate along the channel and with respect to the closure beam.

In at least one embodiment, a surgical instrument is provided that cancomprise an end effector comprising a first jaw including a tissuecontacting surface, a second jaw, a closure beam operably contacting thefirst jaw, and a cutting member defining a longitudinal axis. In theseembodiments, the first jaw and the second jaw can be operably coupledtogether such that the first jaw may move between an open position and aclosed position with respect to the second jaw. Additionally, in theseembodiments, the closure beam can be configured to translate withrespect to the first jaw between a first position and a second position.Further, in these embodiments, the first jaw can be urged to the closedposition by the closure beam when the closure beam is at the secondposition. Also, in these embodiments, the cutting member can beconfigured to translate with respect to the first jaw between aretracted position and a fully advanced position. Additionally, in theseembodiments, the cutting member can be configured to translate withrespect to the closure beam. Moreover, in these embodiments, a planeperpendicular to the cutting member's longitudinal axis can transect thefirst jaw's tissue contacting surface, the closure beam, and the cuttingmember when the closure beam is at the second position and the cuttingmember is at the fully advanced position.

In at least one embodiment, a surgical instrument is provided that cancomprise an end effector comprising a first jaw, a second jaw, a closurebeam operably contacting the first jaw, a cutting member configured totranslate with respect to the first jaw, and an interlocking member. Inthese embodiments, the first jaw and the second jaw can be operablycoupled together such that the first jaw may move between an openposition and a closed position with respect to the second jaw.Additionally, in these embodiments, the closure beam can be configuredto translate with respect to the first jaw between a first position anda second position. Also, in these embodiments, the first jaw can beurged to the closed position by the closure beam when the closure beamis at the second position. Further, in these embodiments, the cuttingmember can be configured to translate with respect to the closure beam.Moreover, in these embodiments, the interlocking member can beconfigured to selectively hold the cutting member and the closure beamtogether such that the cutting member and the closure beam translatesynchronously with each other in at least one direction with respect tothe first jaw.

The foregoing discussion should not be taken as a disavowal of claimscope.

FIGURES

Various features of the embodiments described herein are set forth withparticularity in the appended claims. The various embodiments, however,both as to organization and methods of operation, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a perspective view of a surgical instrument according to anon-limiting embodiment.

FIG. 2 is a side view of a handle of the surgical instrument of FIG. 1with a half of a handle body removed to illustrate some of thecomponents therein.

FIG. 3 is a perspective view of an end effector of the surgicalinstrument of FIG. 1 illustrated in an open configuration; the distalend of a closure beam is illustrated in a retracted position.

FIG. 4 is a perspective view of the end effector of the surgicalinstrument of FIG. 1 illustrated in a closed configuration; the distalend of the closure beam is illustrated in a partially advanced position.

FIG. 5 is a perspective sectional view of a portion of an end effectorof the surgical instrument of FIG. 1.

FIG. 6 is a perspective sectional view of portions of a cutting memberand a closure beam of a surgical instrument of the surgical instrumentof FIG. 1.

FIG. 7 is a schematic side view of a distal portion of the surgicalinstrument of FIG. 1 showing the closure beam being advanced by thecutting member towards an open pair of jaws.

FIG. 8 is a schematic side view of a distal portion of the surgicalinstrument of FIG. 1 showing the closure beam fully advanced into one ofthe now-closed jaws.

FIG. 9 is a schematic side view of a distal portion of the surgicalinstrument of FIG. 6 showing the cutting member retracted distally torelease a spring-loaded pawl that is rotatably mounted to the closurebeam.

FIG. 10 is a perspective cut-away view of a distal portion of a surgicalinstrument gripping tissue according to a non-limiting embodiment;various internal components are shown and some components have beenomitted for clarity.

FIGS. 11-13 are side views of portions of a jaw, a closure beam, a pawl,and a cutting member of the surgical instrument of FIG. 10 in variousconfigurations.

FIGS. 14-21 are schematic side views of the jaw, the closure beam, thepawl, and a distal portion of the cutting member of the surgicalinstrument of FIG. 10 in various configurations to illustrate theinteraction between and operation of the above-listed components.

FIG. 22 is a perspective view of a distal portion of a surgicalinstrument according to a non-limiting embodiment; various internalcomponents are shown in perspective sectional form and some componentsare omitted for the purposes of clarity.

FIG. 23 is a perspective sectional view of a portion of an elongateshaft, a closure beam, a cutting member, and a nub of the surgicalinstrument of FIG. 22.

FIG. 24 is a cross-sectional view of jaws of the surgical instrument ofFIG. 22, taken transverse to a longitudinal axis of the jaws.

FIG. 25 is a cross-sectional view of the jaws and a portion of theelongate shaft of the surgical instrument of FIG. 22, taken along line25-25 in FIG. 24.

FIG. 26 is a perspective view of a distal portion of an end effector ofthe surgical instrument of FIG. 22; the end effector is shown gripping,sealing, and/or cutting tissue.

FIG. 27 is a perspective view of a distal portion of the surgicalinstrument of FIG. 22 with the jaws in an open configuration and theclosure beam and the cutting member in a retracted position; variousinternal components are shown in perspective sectional form for thepurposes of clarity.

FIG. 28 is a perspective view of a distal portion of the surgicalinstrument of FIG. 22 with the jaws in a closed configuration and theclosure beam and/or cutting member at least partially advanced throughthe jaws; various internal components are shown in perspective sectionalform for the purposes of clarity.

FIG. 29 is a side view of a surgical instrument according to anon-limiting embodiment; various portions of the instrument are cut awayand/or shown in cross-sectional form for the purposes of clarity.

FIG. 30 is a flowchart showing various stages or states of operation ofa surgical instrument according to a non-limiting embodiment.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments, in one or more forms, and suchexemplifications are not to be construed as limiting the scope of theclaims in any manner.

DETAILED DESCRIPTION

Various embodiments are directed to apparatuses, systems, and methodsfor the treatment of tissue. Numerous specific details are set forth toprovide a thorough understanding of the overall structure, function,manufacture, and use of the embodiments as described in thespecification and illustrated in the accompanying drawings. It will beunderstood by those skilled in the art, however, that the embodimentsmay be practiced without such specific details. In other instances,well-known operations, components, and elements have not been describedin detail so as not to obscure the embodiments described in thespecification. Those of ordinary skill in the art will understand thatthe embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative and do notnecessarily limit the scope of the embodiments, the scope of which isdefined solely by the appended claims.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment,” or “in an embodiment,” or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the features,structures, or characteristics of one or more other embodiments withoutlimitation.

It will be appreciated that the terms “proximal” and “distal” may beused throughout the specification with reference to a clinicianmanipulating one end of an instrument used to treat a patient. The term“proximal” refers to the portion of the instrument closest to theclinician and the term “distal” refers to the portion located farthestfrom the clinician. It will be further appreciated that for concisenessand clarity, spatial terms such as “vertical,” “horizontal,” “up,” and“down” may be used herein with respect to the illustrated embodiments.However, surgical instruments may be used in many orientations andpositions, and these terms are not intended to be limiting and absolute.

The entire disclosures of the following non-provisional United Statespatents are hereby incorporated by reference herein:

U.S. Pat. No. 7,381,209, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,354,440, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,311,709, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,309,849, entitled POLYMER COMPOSITIONS EXHIBITING A PTCPROPERTY AND METHODS OF FABRICATION;

U.S. Pat. No. 7,220,951, entitled SURGICAL SEALING SURFACES AND METHODSOF USE;

U.S. Pat. No. 7,189,233, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,186,253, entitled ELECTROSURGICAL JAW STRUCTURE FORCONTROLLED ENERGY DELIVERY;

U.S. Pat. No. 7,169,146, entitled ELECTROSURGICAL PROBE AND METHOD OFUSE;

U.S. Pat. No. 7,125,409, entitled ELECTROSURGICAL WORKING END FORCONTROLLED ENERGY DELIVERY; and

U.S. Pat. No. 7,112,201, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE.

Various embodiments of systems and methods relate to creating thermal“welds” or “fusion” within native tissue volumes. The alternative termsof tissue “welding” and tissue “fusion” may be used interchangeablyherein to describe thermal treatments of a targeted tissue volume thatresult in a substantially uniform fused-together tissue mass, forexample, in welding blood vessels that exhibit substantial burststrength immediately post-treatment. The strength of such welds isparticularly useful for (i) permanently sealing blood vessels in vesseltransection procedures; (ii) welding organ margins in resectionprocedures; (iii) welding other anatomic ducts wherein permanent closureis required; and also (iv) for performing vessel anastomosis, vesselclosure or other procedures that join together anatomic structures orportions thereof. The welding or fusion of tissue as disclosed herein isto be distinguished from “coagulation”, “hemostasis” and other similardescriptive terms that generally relate to the collapse and occlusion ofblood flow within small blood vessels or vascularized tissue. Forexample, any surface application of thermal energy can cause coagulationor hemostasis—but does not fall into the category of “welding” as theterm is used herein. Such surface coagulation does not create a weldthat provides any substantial strength in the treated tissue.

At the molecular level, the phenomena of truly “welding” tissue asdisclosed herein may result from the thermally-induced denaturation ofcollagen and other protein molecules in a targeted tissue volume tocreate a transient liquid or gel-like proteinaceous amalgam. A selectedenergy density is provided in the targeted tissue to cause hydrothermalbreakdown of intra- and intermolecular hydrogen crosslinks in collagenand other proteins. The denatured amalgam is maintained at a selectedlevel of hydration—without desiccation—for a selected time intervalwhich can be very brief. The targeted tissue volume is maintained undera selected very high level of mechanical compression to insure that theunwound strands of the denatured proteins are in close proximity toallow their intertwining and entanglement. Upon thermal relaxation, theintermixed amalgam results in protein entanglement as re-crosslinking orrenaturation occurs to thereby cause a uniform fused-together mass.

A surgical instrument can be configured to supply energy, such aselectrical energy, ultrasonic energy, and/or heat energy, for example,to the tissue of a patient. For example, various embodiments disclosedherein provide electrosurgical jaw structures adapted for transectingcaptured tissue between the jaws and for contemporaneously welding orsealing the captured tissue margins with controlled application of RFenergy. In more detail, in various embodiments, referring now to FIG. 1,an electrosurgical instrument 100 is shown. Surgical or electrosurgicalinstrument 100 can comprise a proximal handle 105, a distal working endor end effector 110 and an introducer or elongate shaft 108 disposedin-between and at least partially operably coupling the handle 105 tothe end effector 110. End effector 110 may comprise a set ofopenable-closeable jaws with straight or curved jaws—an upper first jaw120A and a lower second jaw 120B. The jaws 120A and 120B may be operablycoupled together such that the first jaw 120A may move between an openposition (see FIG. 3) and a closed position (see FIG. 4) with respect tothe second jaw 120B. First jaw 120A and second jaw 120B may eachcomprise an elongate slot or channel 142A and 142B (see FIG. 3),respectively, disposed outwardly along their respective middle portions.First jaw 120A and second jaw 120B may be coupled to an electricalsource 145 and a controller 150 through electrical leads in cable 152.Controller 150 may be used to activate electrical source 145. In variousembodiments, the electrical source 145 may comprise an RF source, anultrasonic source, a direct current source, and/or any other suitabletype of electrical energy source, for example.

Moving now to FIG. 2, a side view of the handle 105 is shown with halfof a first handle body 106A (see FIG. 1) removed to illustrate some ofthe components within second handle body 106B. Handle 105 may comprise alever arm or trigger 128 extending from the handle body 106A and/or106B. The trigger 128 may be pulled along a path 129 such that thetrigger 128 moves with respect to body 106A and/or 106B. The trigger 128may also be operably coupled to a movable cutting member 140 disposedwithin elongate shaft 108 by a shuttle 146 operably engaged to anextension 127 of trigger 128. Accordingly, movement of the trigger 128relative to the handle body 106A and/or 106B may cause the cuttingmember 140 to translate with respect to one or both of jaws 120A and120B (see FIG. 1). Also, as described in more detail below, the cuttingmember 140 may be releasably engaged with a closure beam 170 (see FIGS.3-4) that is also movably associated with the jaws 120A, 120B. Theshuttle 146 may further be connected to a biasing device, such as spring141, which may also be connected to the second handle body 106B, to biasthe shuttle 146 and thus the cutting member 140 and/or the closure beam170 (FIG. 3) in a proximal direction, thereby urging the jaws 120A and120B to an open position as seen in FIG. 1. Also, referring to FIGS. 1and 2, a locking member 131 (see FIG. 2) may be moved by a lockingswitch 130 (see FIG. 1) between a locked position, where the shuttle 146is substantially prevented from moving distally as illustrated, and anunlocked position, where the shuttle 146 may be allowed to freely movein the distal direction, toward the elongate shaft 108. The handle 105can be any type of pistol-grip or other type of handle known in the artthat is configured to carry actuator levers, triggers or sliders foractuating the first jaw 120A and second jaw 120B. Elongate shaft 108 mayhave a cylindrical or rectangular cross-section and can comprise athin-wall tubular sleeve that extends from handle 105. Elongate shaft108 may include a bore extending therethrough for carrying actuatormechanisms, such as cutting member 140 and/or closure beam 170, forexample, for actuating the jaws and for carrying electrical leads fordelivery of electrical energy to electrosurgical components of endeffector 110.

End effector 110 may be adapted for capturing, welding or sealing, andtransecting tissue. First jaw 120A and second jaw 120B may close tothereby capture or engage tissue about a longitudinal axis 125 definedby cutting member 140. First jaw 120A and second jaw 120B may also applycompression to the tissue. Elongate shaft 108, along with first jaw 120Aand second jaw 120B, can be rotated a full 360 degrees, as shown byarrow 117, relative to handle 105 through, for example, a rotary triplecontact. First jaw 120A and second jaw 120B can remain openable and/orcloseable while rotated.

FIGS. 3 and 4 illustrate perspective views of end effector 110. FIG. 3shows end effector 110 in an open configuration and FIG. 4 shows endeffector 110 in a closed configuration. As noted above, the end effector110 may comprise the upper first jaw 120A and the lower second jaw 120B.Further, the first jaw 120A and second jaw 120B may each havetissue-gripping elements, such as teeth 143, disposed on the innerportions of first jaw 120A and second jaw 120B. First jaw 120A maycomprise an upper first jaw body 161A with an upper first outward-facingsurface 162A and an upper first energy delivery surface 175A of a firstelectrode, for example. Second jaw 120B may comprise a lower second jawbody 161B with a lower second outward-facing surface 162B and a lowersecond energy delivery surface 175B of a second electrode, for example.First energy delivery surface 175A and second energy delivery surface175B may both extend in a “U” shape about the distal end of end effector110. The energy delivery surfaces 175A, 175B may provide a tissuecontacting surface or surfaces for contacting, gripping, and/ormanipulating tissue therebetween.

Referring to FIGS. 3-5, in at least one embodiment, the closure beam 170and the cutting member 140 may be sized and configured to fit at leastpartially within the channel 142A of the first jaw 120A. As seen in FIG.5, the cutting member 140 may also be sized and configured to fit atleast partially within the channel 142B of the second jaw 120B. In anyevent, the closure beam 170 and the cutting member 140 may translatealong the channel 142A between a first, retracted position correlatingwith the first jaw being at the open position (FIG. 3), and a second,advanced position correlating with the second jaw being at the closedposition (see, for example, FIG. 4). The trigger 128 of handle 105, seeFIG. 2, may be adapted to actuate cutting member 140 and, subsequently,closure beam 170, which also functions as a jaw-closing mechanism. Forexample, cutting member 140 and/or closure beam 170 may be urgeddistally as trigger 128 is pulled proximally along path 129 via shuttle146, seen in FIG. 2 and discussed above. The cutting member 140 andclosure beam 170 may each comprise one or several pieces, but in anyevent, may each be movable or translatable with respect to the elongateshaft 108 and/or jaws 120A, 120B. Also, in at least one embodiment, thecutting member 140 may be made of 17-4 precipitation hardened stainlesssteel. The distal portion of cutting member 140 may comprise a flanged“I”-beam configured to slide within channels 142A and 142B in jaws 120Aand 120B. In at least one embodiment, the distal portion of closure beam170 may comprise a “C”-shaped beam configured to slide within one ofchannels 142A and 142B. As illustrated in FIGS. 3-5, the closure beam isshown residing in and/or on channel 142A of the first jaw 120A. Closurebeam 170 may slide within channel 142A, for example, to open and closefirst jaw 120A with respect to second jaw 120B. The distal portion ofclosure beam 170 may also define inner cam surfaces 174 for engagingoutward facing surfaces 162A of the first jaw 120A, for example.Accordingly, as the closure beam 170 is advanced distally through thechannel 142A, from, for example, a first position (FIG. 3) to a secondposition (FIG. 4), the first jaw 120A may be urged closed (FIG. 4). Theclosure beam may also be guided by upper walls 165 of the first jaw120A, which as seen in FIG. 5 may at least partially envelope theclosure beam 170. The upper walls 165 have been omitted from FIGS. 3-4for purposes of clarity.

Additionally, in various embodiments, the cutting member 140 may besized and configured to at least partially fit or slide within theclosure beam 170, such as within an inner channel 171 of the closurebeam 170, for example. In at least one embodiment, as seen in FIG. 5,while part of the cutting member 140 may be positioned within theclosure beam 170, a portion of the cutting member 140 may protrude fromthe closure beam 170 in a direction transverse to a longitudinal axis172 defined by the closure beam 170. The flanges 144A and 144B ofcutting member 140 may define inner cam surfaces for engaging the innerchannel 171 of the closure beam 170 and the outward facing surfaces 162Bof the second jaw 120B. As discussed in greater detail below, theopening and closing of jaws 120A and 120B can apply very highcompressive forces on tissue using cam mechanisms which may includereciprocating “C-beam” closure beam 170 and/or “I-beam” cutting member140 and the outward facing surfaces 162A, 162B of jaws 120A, 120B.

More specifically, referring still to FIGS. 3-5, collectively, flanges144A and 144B of the distal end of cutting member 140 may be adapted toslidably engage the inner channel 171 of the closure beam 170 and thesecond outward-facing surface 162B of the second jaw 120B, respectively.Channel 142A within first jaw 120A and channel 142B within second jaw120B may be sized and configured to accommodate the movement of closurebeam 170 and/or cutting member 140, which may comprise a tissue-cuttingelement, for example, a sharp distal edge and/or surface 153 (see FIG.6). FIG. 4, for example, shows the distal end 178 of the closure beam170 advanced at least partially through channel 142A. The advancement ofthe closure beam 170 can close the end effector 110 from the openconfiguration shown in FIG. 3 to the closed configuration shown in FIG.4. The closure beam 170 may move or translate along the channel 142Abetween a first, refracted position and a second, fully advancedposition. The retracted position can be seen in FIG. 3, where the jaws120A, 120B are in an open position and a distal end 178 of the closurebeam 170 is positioned proximal to the upper outward-facing surface162A. The fully advanced position, while not shown, may occur when thedistal end 178 of the closure beam 170 is advanced to a distal end 164of channel 142A and the jaws are in a closed position, see FIG. 4.Likewise, the cutting member 140 (FIG. 5) may be configured to translatewith respect to the first jaw between a retracted position, where thejaws 120A, 120B are in an open position (FIG. 3) and a fully advancedposition where the cutting member is advanced to the distal end 164 ofthe channel 142A, for example, with the jaws in a closed position (FIG.4). As noted above, the cutting member 140 may also translate withrespect to the closure beam 170 as the closure beam 170 is beingadvanced through the jaws 120A, 120B. At a point, however, the cuttingmember 140 may be decoupled from the closure beam 170 as discussed inmore detail below. Accordingly, the advancing of the closure beam 170may apply an initial, lower level or amount of compression pressure orforce to tissue gripped between the jaws 120A, 120B and subsequentadvancing of the cutting member 140 relative to the closure beam 170, asdiscussed below, may not only cut or sever tissue, but may also apply ahigher level or amount of compression pressure or force to tissuegripped between the jaws 120A, 120B. The higher level or amount ofcompression provided by the cutting member 140 to gripped tissue may bedue to the fact that the closure beam 170 may only apply force to thefirst jaw 120A, whereas the cutting member 140 may apply force to bothjaws 120A and 120B. The lower level or amount of compression may bedesirable when tissue is only being manipulated, whereas the higherlevel or amount of compression may be desirable when tissue is beingenergetically sealed and/or transected.

In at least one embodiment, distal portions of the closure beam 170 andthe cutting member 140 may be positioned within and/or adjacent to oneor both of jaws 120A and 120B of the end effector 110 and/or distal tothe elongate shaft 108. More specifically, referring to FIG. 5, a planethat is perpendicular to the cutting member's longitudinal axis 125,such as the plane cross-sectioning the end effector 110 in FIG. 5, forexample, may transect the closure beam 170, the cutting member 140, anda tissue contacting surface of the first jaw 120A, such as energydelivery surface 175A, for example, when closure beam 170 is at asecond, fully advanced position and the cutting member 140 is also atits fully advanced position. Such a plane may also transect a tissuecontacting surface of the second jaw 120B, such as energy deliverysurface 175B, for example, likewise when the closure beam 170 is at asecond, fully advanced position and the cutting member is also at itsfully advanced position.

Further, in the closed position shown by FIG. 4, upper first jaw 120Aand lower second jaw 120B define a gap or dimension D between the firstenergy delivery surface 175A and second energy delivery surface 175B offirst jaw 120A and second jaw 120B, respectively. Dimension D may equalfrom about 0.0005″ to about 0.040″, for example, and preferably betweenabout 0.001″ to about 0.010″, for example. Also, the edges of firstenergy delivery surface 175A and second energy delivery surface 175B maybe rounded to prevent the dissection of tissue.

Referring now to FIGS. 1 and 3, end effector 110 may be coupled toelectrical source 145 and controller 150. First energy delivery surface175A and second energy delivery surface 175B may likewise each becoupled to electrical source 145 and controller 150. First energydelivery surface 175A and second energy delivery surface 175B may beconfigured to contact tissue and deliver electrosurgical energy toengaged tissue which is adapted to seal or weld the tissue. Controller150 can regulate the electrical energy delivered by electrical source145 which in turn delivers electrosurgical energy to firstenergy-delivery surface 175A and second energy-delivery surface 175B.The energy delivery may be initiated by an activation button 124operably engaged with trigger 128 and in electrical communication withcontroller 150 via cable 152. As mentioned above, the electrosurgicalenergy delivered by electrical source 145 may comprise radiofrequency(RF) energy. Further, the opposing first and second energy deliverysurfaces 175A and 175B may carry variable resistive positive temperaturecoefficient (PTC) bodies that are coupled to electrical source 145 andcontroller 150. Additional details regarding electrosurgical endeffectors, jaw closing mechanisms, and electrosurgical energy-deliverysurfaces are described in the following U.S. patents and publishedpatent applications, all of which are incorporated herein in theirentirety by reference and made a part of this specification: U.S. Pat.Nos. 7,381,209; 7,311,709; 7,220,951; 7,189,233; 7,186,253; 7,125,409;7,112,201; 7,087,054; 7,083,619; 7,070,597; 7,041,102; 7,011,657;6,929,644; 6,926,716; 6,913,579; 6,905,497; 6,802,843; 6,770,072;6,656,177; 6,533,784; and 6,500,176; and U.S. Pat. App. Pub. Nos.2010/0036370 and 2009/0076506.

In various embodiments, it may be desirable to close the jaws 120A,120B, before advancing the cutting member 140 therethrough. Accordingly,referring to FIGS. 3-5, the closure beam 170 may be advanced at leastpartially through the channel 142A prior to the cutting member 140 beingadvanced into the channel 142A. In such embodiments, an interlockingmember may selectively hold the cutting member 140 and the closure beam170 together such that they translate synchronously with each other inat least one direction with respect to the first jaw until theinterlocking member decouples the cutting member 140 from the closurebeam 170, after which the cutting member 140 may be advanced through thechannels 142A, 142B in jaws 120A, 120B and/or through the closure beam170. In at least one embodiment, referring to FIG. 6, the interlockingmember may comprise a pawl, such as pawl 180, rotatably mounted to theclosure beam 170 or to the cutting member 140. As illustrated in FIG. 6,the pawl may be rotatably mounted to at least one inner surface of theclosure beam channel 171 at a hole 181 in the pawl 180. The pawl 180 maybe rotatable between a first, locked position (shown in phantom lines inFIG. 6) and a second, unlocked position (shown in solid lines in FIG.6). A biasing member (not shown), such as a torsion spring, for example,may bias the pawl in the direction of arrow 182, towards the unlockedposition. As will be explained in more detail below, a proximal end 183of the pawl 180 may be configured to engage various portions of thecutting member 140. For example, in at least one embodiment, the distalend 148 of the cutting member 140 may be engaged by the proximal end 183of the pawl 180 when the pawl 180 is in the locked position.Additionally, in at least one embodiment, the proximal end 183 of thepawl 180 may be slidably received in a recess 156 formed in the cuttingmember 140 when the pawl 180 is in the unlocked position.

The pawl 180 may selectively interconnect the cutting member 140 and theclosure beam 170 as follows. Referring to FIGS. 7 and 8, the closurebeam 170 may be advanced from a refracted, initial position (FIG. 7) toa fully advanced position (FIG. 8) when a user pulls the trigger 128(see FIGS. 1-2) towards the handle body 106A or 106B. Pulling on thetrigger 128 in such a fashion moves the cutting member 140 distally and,as a result, the closure beam 170 may likewise be moved distally owingto the pawl's proximal end 183 being forced in a distal direction by thecutting member's distal end 148. Friction and/or interference betweenthe pawl's proximal end 183 and the cutting member's distal end 148 mayhold the pawl 180 in its locked position when the cutting member 140 isstill or moving distally. After advancing the closure beam 170 to closethe jaws 120A, 120B (FIG. 8), the cutting member 140 may be advancedrelative to the closure beam 170. A user may be provided with feedback,such as haptic feedback (discussed in more detail below), for example,when the closure beam 170 is stopped from moving distally by the distalend 164of the first jaw's channel 142A (see FIG. 4). To unlock the pawl180, a user may move, or return, the trigger 128 (FIGS. 1-2) slightlyaway from the handle body 106A and/or 106B. Referring to FIG. 9, movingthe trigger 128 in such a manner may move the cutting member 140proximally such that the pawl 180 may be released from its lockedposition (phantom lines in FIG. 9) and rotate to its unlocked position(solid lines) in the direction of arrow 182 owing to the presence of thebiasing member (not shown). After the pawl 180 is in its unlockedposition, the cutting member 140 may be advanced by a user by moving thetrigger back towards the handle body 106A and/or 106B once again. Thecutting member 140 may now move into and/or through the jaws 120A and120B independently of closure beam 170 because the pawl 180 may slideinto the cutting member recess 156.

Alternative pawl configurations are also possible. For example,referring now to FIG. 10, a distal portion of a surgical instrument 200is illustrated gripping tissue T; various portions of the illustratedinstrument 200 have been omitted for clarity. The surgical instrument200 may be generally similar to surgical instrument 100 described above.For example, the surgical instrument 200 may comprise a handle 105(FIG. 1) operably coupled to an end effector 210 by an elongate shaft108. The end effector 210 may comprise openable and closable jaws 220Aand 220B that are closed by the relative advancement of a closure beam270 driven by a cutting member 240. The cutting member 240 may be movedrelative to the jaws 220A, 220B when a user moves a trigger, which canbe similar to trigger 128 (see FIGS. 1-2), relative to a handle body,which can be similar to handle bodies 106A and/or 106B (see FIGS. 1-2).The cutting member 240 and the closure beam 270 may be selectively heldtogether or interlocked by an interlocking member, such as pawl 280rotatably or pivotably mounted to an inner portion of the closure beam270, for example. Additionally, referring to FIG. 11, the pawl 280 maybe rotatably as well as translatably mounted to the closure beam 270 bya pawl pin 285 received in an arcuate slot 284 of the closure beam 270.A biasing member (not shown) may bias the spring towards a neutralposition as shown in FIG. 11. The pawl 280 may rotate in the directionindicated by arrow 286, away from the closure beam 270, or the pawl 280may rotate in the direction indicated by arrow 287, toward the closurebeam 270; however, in the absence of an external force on the pawl 280,the pawl 280 may be biased toward the neutral position seen in FIG. 11.An indentation 221 formed in inner surface of first jaw 220A mayfacilitate the pawl 285 in translating along the slot 284 when the pawl280 is positioned adjacent to the indentation 221.

The pawl 280 may selectively hold the closure beam 270 and the cuttingbeam together at least partially due to friction between the pawl 280and the cutting member 240. Accordingly, when the pawl is at the neutralposition seen in FIG. 11, sufficient friction and/or interference mayexist between the pawl 280 and the closure beam's distal end 248 suchthat the closure beam 270 may be advanced by the cutting member 240 atleast partially through the first jaw 220A (FIG. 10) such that the jaw220A at least partially closes. After or while closing the jaws 220A,220B, the closure beam 270 may experience sufficient resistive forces,such as from gripping tissue, for example, that may allow the pawl torotate to a collapsed position such as that shown in FIG. 12, forexample. Continued advancement of the cutting member 240 in a distaldirection, such as that indicated by arrow “D” in FIG. 12, for example,may still advance the closure beam 270 in the distal direction D due tosufficient friction between the outer surfaces of the biased pawl 280and the cutting member 240. However, after the closure beam 270 reachesthe distal end of the jaw's channel (not shown, see the channel's distalend 164 in FIG. 4, for example), the cutting member 240 may then beadvanced further relative to both the closure beam 270 and the jaws220A, 220B (FIG. 10). In such situations, the resistive friction forcesbetween the pawl 280 and the cutting member 240 may be overcome suchthat the cutting member 240 slides relatively against the pawl 280.Referring to FIG. 13, the cutting member 240 may be retracted in aproximal direction, such as that indicated by arrow “P,” for example,until the pawl 280 is forced into an extended position in a recess 256of the cutting member 240, thereby interconnecting the closure beam 280to the cutting member 240 for retracting the cutting member 240 and theclosure beam 280 from the jaws 220A, 220B (FIG. 10). After the closurebeam 270 has been sufficiently retracted, the jaws may open.

FIGS. 14-21 provide a schematic set of diagrams that further illustratethe operation of the pawl 280, a distal portion of the cutting member240, the closure beam 270, and the jaw 220A; other components have beenomitted for clarity. As shown in FIG. 14, the closure beam is in aretracted, resting position. As the cutting member 240 is advanceddistally, toward the jaw 220A, the closure beam 270 may likewise beadvanced owing to friction and/or interference between the pawl 280 andthe cutting member 240. As the closure beam 270 is advanced into,through, and/or adjacent to the jaw 220A, the jaw 220A may be urged intoa closed position such as that shown in FIG. 15. As seen in FIG. 15, thepawl has already been rotated to a collapsed position by the advancementof the cutting member 240 relative to the jaw 220A and/or the closurebeam 270. However, sufficient friction may exist between the biased pawl280 and the cutting member 240 such that the closure beam 270 and thecutting member 240 may still be translationally interconnected orinterlocked. Accordingly, as seen in FIG. 16, the jaw 220A may bereopened by retracting the cutting member 240 in a proximal direction,away from the jaw 220A such that the closure beam 270 also retractsproximally. Retracting the cutting member 240 in such a fashion maylikewise cause the closure beam 270 to retract distally, until theclosure beam 270 reaches a stop 209 positioned inside the elongate shaft108 (FIG. 11), for example. Referring still to FIG. 16, after theclosure beam 270 reaches the stop 209, the cutting member 240 maythereafter slide along the pawl 280, until the pawl 280 at leastpartially clears the cutting member 240 such that the pawl 280 is forcedto rotate to its neutral position by the biasing member (not shown). Thecutting member 240, referring to FIG. 17, may thereafter be re-advanced,thereby also re-advancing the closure beam 270 and re-closing the jaw220A.

After the jaw 220A has been closed by the closure beam 270 as seen inFIG. 17, for example, the cutting member 240 may continue to be advanceddistally, thereby also advancing the closure beam 270 due to frictionbetween the pawl 280 and the cutting member 240. Referring to FIG. 18,once the closure beam 270 reaches the jaw's channel's distal end 264(see also the distal end 164 of channel 142A in FIG. 4), the cuttingmember 240 may begin to be slide along the pawl 280 and be advancedthrough the jaws 220A and/or 220B and any tissue T gripped therebetween(see FIG. 10) until the cutting member 240 reaches a fully advancedposition or another desired position.

The closure beam may be retracted from the jaw 220A and the jaw 220A maybe reopened after advancing the cutting member 240 into the jaw 220A asfollows. Referring to FIG. 19, the cutting member 240 may be retractedin a proximal direction, away from channel distal end 264. However,owing to resistive friction from tissue recently cut by and/orpotentially still contacting the sides of the cutting member 240,friction between the pawl 280 and the cutting member 240 may no longerbe sufficient to interlock the closure beam 270 and cutting membertranslationally together. Thus, as the cutting member is retracted, thepawl 280 may be biased into the recess 256 of the cutting member 240,thereby serving as a catch and holding the cutting member 240 and theclosure beam 270 together by way of interference between the pawl 280and the recess 256. Accordingly, further retraction of cutting member240 in a proximal direction, i.e., away from the channel distal end 264,may begin moving the closure beam 270 in a proximal direction also. Asshown in FIGS. 10-21, the recess 256 may be positioned proximate orclose to the distal end of the cutting member 240. However,alternatively, the recess may be positioned farther away from the distalend of the cutting member 240 than shown. For example, in oneembodiment, the recess 256 may be positioned relative to the jaw 220Asuch that the pawl 280 may be received in the recess 256 when thecutting member 240 reaches a fully advanced position (see FIG. 18).Accordingly, in such embodiments, the pawl 280 may help hold the cuttingmember 240 and the closure beam 270 together immediately after thecutting member 240 is fully advanced and/or during the cutting member'sretraction. In any event, referring to FIG. 20 and in at least oneembodiment, after the closure beam 270 has been at least partiallyretracted, the pawl 280 may rotate and translate into another collapsedposition owing to the arcuate slot 284 seen in FIGS. 11-13. Referring toFIG. 21, such movement of the pawl 280 may allow the cutting member 240to be fully refracted to the position seen in FIG. 21, after which thepawl 280 may reset and be biased to its neutral position by the biasingmember (not shown). Alternatively, in at least one embodiment, the pawl280 may return to the neutral position seen in FIG. 11 from the extendedposition shown in FIG. 13 by a user moving, or pulling on, the trigger128 (FIGS. 1-2) slightly toward from the handle body 106A and/or 106Bsuch that the cutting member 240 and recess 256 move distally, therebyallowing the pawl 280 to rotate to a collapsed position, within theclosure beam 270 (see FIG. 12). Subsequently, a user may move, orreturn, the trigger 128 (FIGS. 1-2) more fully away from the handle body106A and/or 106B such that the pawl 280 may return to its neutralposition, thereby resetting the pawl 280. In any event, thereafter, theabove steps and/or relative movements represented in one or more ofFIGS. 14-21 may be repeated to again grasp, manipulate, and/or cuttissue, for example.

Additional details of pawl configurations which may serve as aninterlocking member according to various embodiments may be found inU.S. patent application Ser. No. 11/076,612, entitled MRI BIOPSY DEVICE,the disclosure of which is incorporated by reference herein in itsentirety.

In at least one embodiment, the interlocking member may comprise a nubprotruding from the cutting member. For example, referring to FIGS.22-23, a surgical instrument 300, generally similar to surgicalinstrument 100 described above, may comprise an end effector 310 and ahandle (not shown, see handle 105 in FIG. 1) operably coupled togetherby an elongate shaft 308. The end effector 310 may comprise openable andclosable jaws 320A and 320B that are closed by the relative advancementof a closure beam 370 (not shown for clarity in FIG. 22, see FIG. 23)driven by a cutting member 340. The cutting member 340 may be movedrelative to the jaws 320A, 320B, when a user moves a trigger, which canbe similar to trigger 128 (see FIGS. 1-2) relative to a handle body,which can be similar to handle bodies 106A and/or 106B (see FIGS. 1-2).The cutting member 340 and the closure beam 370 may be selectively heldtogether or interlocked by an interlocking member, such as a nub 380protruding from the top or outer portion of the cutting member 340, forexample. The nub 380 may be unitary and integrally formed with thecutting member 340. Alternatively, the nub 380 may be attached to thecutting member by an adhesive, a weld, a fastening member, and/or anyother suitable type of attachment mechanism, for example.

As seen in FIG. 23, the nub 380 may be configured to engage the closurebeam 380 when the cutting member 340 is at a raised position relative tothe closure beam 380. In such embodiments, the nub 380 may engage, nestin, and/or be otherwise releasably received by a notch or detent 382formed in the inner channel 371 of the closure beam 370. The detent 382may comprise a proximal wall and a distal wall (not shown) that allowthe closure beam 370 to be translationally coupled to the cutting member340 when the cutting member 340, and hence the nub 380, are at theraised position. Alternatively, although not illustrated, in at leastone embodiment, the nub 380 may be attached and/or formed in the closurebeam 370 and the detent 382 may be formed in the cutting member 340.

The nub 380 may be disengaged from the detent 382 when the closure beam370 is at a desired position, such as a fully advanced position,relative to the jaw 320A. Referring now to FIGS. 24-26, the second jaw320B may comprise an outward facing surface 362B. The outward facingsurface 362B may guide the lower flanges 344B of the cutting member 340(FIG. 23) such that the cutting member moves transverse to the closurebeam's longitudinal axis 372 (FIG. 23). As seen in FIG. 25, the outwardfacing surface 362B may further comprise at least one ramped surface363. The ramped surface 363 may contact at least a portion of thecutting member, such as lower flanges 344B, for example, to cause thecutting member 340, and hence the nub 380, to move from the raisedposition seen in FIG. 23, to a lowered position as illustrated in FIG.26, for example, when the cutting member 340 is advanced in a distaldirection. In other words, the cutting member 340 and the nub 380 may bemoved transverse to the closure beam's longitudinal axis 372 (FIG. 23)as the lower flanges 344B of cutting member 340 are advanced distallyalong the ramped surface 363. In such a lowered position (FIG. 26), thenub 380 may be disengaged from the detent 382 of the closure beam 370.The cutting member 340 may thus move relative to the jaws 320A, 320B andto the closure beam 370. In other words, when the nub 380 is at thelowered position, the cutting member 340 may move independently from theclosure beam 370, without affecting the latter's position relative tothe jaws 320A, 320B. Likewise, as the cutting member 340 is retracted ina proximal direction, the ramped surface 363 may cause the cuttingmember 340 and the nub 380 to move back to the raised position, therebyinterlocking the closure beam 370 and the cutting member 340 via theinterface between the nub 380 and the detent 382. Further, the uppercutting member flanges 344A may move within the closure beam 370 as thecutting member 340 translates between the raised and lowered positionssuch that the flanges 344A contact and/or press against the innersurfaces of the closure beam 370 when the cutting member is at thelowered position.

Referring to FIGS. 27-28, the surgical instrument 300 may be operated asfollows. The first jaw 320A may be rotated from an open position (FIG.27) to a closed position (FIG. 28) as the cutting member 340 and theclosure beam 370 are advanced synchronously due to the nub 380 beingpositioned within the detent 382, thereby interlocking the cuttingmember 340 and the closure beam 370. The closure beam 370 may beadvanced through the end effector 310, along the first jaw's outwardfacing surface 362A, and ahead of the cutting member 340, until theclosure beam 370 reaches the distal end 364A (see FIG. 25) of the firstjaw's channel 342A (FIG. 24) or another predetermined position. At orabout the same time, the lower flanges 344B of the cutting member 340may encounter the ramped surface 363 (FIG. 25) which may cause thecutting member 340 and the nub 380 to move from the raised position(FIG. 27) to the lowered position (FIG. 28) relative to the closure beam370. Thereafter, because the nub 380 may no longer be positioned withinthe detent 382, the cutting member 340 may be advanced distallyindependent of the closure beam 370, thereby severing tissue “T,” in theprocess.

In various embodiments described above, a trigger, such as trigger 128seen in FIGS. 1-2, may be configured to actuate a cutting member, suchas cutting member 140, 240, and/or 340, and a closure beam, such asclosure beam 170, 270, and/or 370, for example, such that the closurebeam and the cutting member translate with respect to a first jaw, suchas jaw 120A, 220A, and/or 320A, for example. Such actuation of both theclosure beam and the cutting member may provide a user with the abilityto control the closing of the jaw(s) and the firing of the cuttingmember through the jaw(s) by only using one trigger. In suchembodiments, a handle trigger may be configured to provide hapticfeedback to a user such that the user is provided with feedback as towhere the surgical instrument is in the closing, sealing, and/or cuttingstages.

Referring now to FIG. 29, a simplified illustration of a surgicalinstrument 400 is shown. A portion of the handle body 406B is cut awayto show some of the inner components positioned inside the handle body406A of the handle. The surgical instrument 400 may be generally similarto surgical instrument 100 described above. For example, as seen in FIG.29, the surgical instrument 400 may comprise a handle operably coupledto an end effector 410 by an elongate shaft 408. The end effector 410may comprise openable and closable jaws 420A and 420B that are closed bythe relative advancement of a closure beam 470 driven by a cuttingmember 440. The cutting member 440 may be moved relative to the jaws420A, 420B, when a user moves a trigger, such as trigger 428, forexample, relative to a thumb rest 432 formed in handle bodies 106Aand/or 106B. The cutting member 440 may be selectively interlocked witha closure beam 470 by one or more of the interlocking members describedabove. Additionally, in at least one embodiment, the interlockingmember(s) may be positioned within the handle and/or proximal to theelongate shaft 408 at least initially, prior to closing the jaws 420A,420B and/or firing the cutting member 440 therethrough.

In more detail, the trigger 428 may be coupled to a pinion or gear 427which may be operably engaged with a rack 446. Teeth of the gear 427 maysuitably mesh with teeth of the rack 446 such that when a user rotatesthe trigger 428 towards or away from the thumb rest 432, the gear 426rotates, thereby causing the rack 446 to translate in a distal orproximal direction, as indicated by the arrows demarcated “D” and “P,”respectively. The rack 446 may be coupled to the cutting member 440.Accordingly, movement of the trigger relative to the thumb rest 432 maycause the gear 427 to rotate, which may cause the rack 446 to translate,which may subsequently cause the cutting member 440 and/or the closurebeam 470 to also translate with respect to the jaws 420A, 420B asdescribe above in various embodiments.

The gear 427 and/or rack 446 may further comprise one or more enlargedor otherwise abnormal teeth that may cause the user to feel aninterference, hear a click, and/or receive any other suitable hapticfeedback during the rotation of the trigger 428 relative to the thumbrest 432, for example. Such haptic feedback may be provided when thetrigger 428 is at a certain predefined position or positions, such aspositions 491, 492, and/or 493. The first position 491 may correlatewith the end effector 410 in an initial, open position as shown. Pullingthe trigger 428 to the second position 492 may provide haptic feedbackcorrelating with the jaws 420A, 420B being in a closed position. Thethird position 493 may correlate with the cutting member 440 being atthe fully advanced position (not shown; see the relative position ofcutting member 240 in FIG. 18, for example). Accordingly, a user may beprovided with haptic feedback when the end effector 410 is at a variousstages, which may be helpful when the user cannot see the end effector410, for instance, when the surgical instrument 400 is being used duringa surgical procedure and the end effector 410 is inside a patient'sbody.

In at least one embodiment, the surgical instrument 400 may beelectrically coupled to a controller 150 and an electrical source 145via a cable 152 as described above. In such embodiments, the endeffector 410 may comprise energy delivery surfaces 475A, 475B, similarto energy delivery surfaces 175A, 175B also described above. The energydelivery surfaces 475A, 475B may be electrically coupled with the cable152 such that electrical energy may be provided to the surfaces 475Aand/or 475B. In such embodiments, the trigger 428 may cause thecontroller 150 to allow the electrical source to provide electricalcurrent to the energy delivery surfaces 475A and/or 475B when thetrigger is at a certain predetermined position or positions. Forexample, the trigger 428 may be electrically coupled to the controller145 such that as the trigger is moved to an intermediate position,sequentially between the second position 492 and the third position 493,the energy delivery surfaces 475A and/or 475B may be energized when thetrigger is at the intermediate position. Accordingly, a user may squeezethe trigger 428 to the second position 492, again correlating with thejaws 420A, 420B in a closed configuration, and then the user may knowthat shortly after continuing to squeeze the trigger 428 toward thethird position 493, the energy delivery surfaces 475A and/or 475B may beactivated to weld tissue. The intermediate position correlating with theenergy activation, may be configured such that electrical current beginsto flow to the energy delivery surfaces 475A and/or 475B before thecutting member 440 begins to enter the space or gap between the jaws420A, 420B. Such a configuration may allow outer tissue layers, such asa vessel's outer adventitia layers, for example, to be compressed beforeenergy is applied thereto. Accordingly, target tissue may be welded,ablated, sealed, or otherwise energetically modified before the cuttingmember begins to sever the target tissue.

FIG. 30 illustrates a flowchart 500 showing the various stages or statesof a surgical instrument according to one or more embodiments herein.State “G” 501 is reached when tissue is grasped by sliding a closurebeam, such as closure beams 170, 270, 370, and/or 470, for example,forward, towards, and/or into a jaw, such as jaw 120A, 220A, 320A,and/or 420A, for example, such that the jaw closes. From state G 501,the tissue may be manipulated. The tissue may be released by retractingthe closure beam to reach state “R” 506, after which states G and M, 501and 502, respectively, may be revisited. After sufficiently manipulatingthe tissue at state M 502, the user may activate the energy deliverysurfaces, such as energy delivery surfaces 175A, 175B, 475A, and/or475B, for example, by continuing to squeeze a trigger, such as trigger128 and/or 428, for example, to create a first sealed tissue area. Thetissue may be manipulated further at state “M′” 505 by keeping the jawsclosed. Thereafter, the tissue may be released at state R 506 and thenre-grasped at a different position, for example, one that is contiguouswith the first sealed tissue area, at state G 501 again. The tissue mayagain be manipulated at state M 502 and then sealed at state E 503 againto create a second sealed area. This may be repeated until a sufficientsealed area is created. Thereafter, the sealed tissue may be cut orsevered at state “K” 504 by squeezing the trigger further such that acutting member, such as cutting member 140, 240, 340, and/or 440, forexample, slides distally and then proximally after cutting the tissue.Then, the cut and sealed tissue may be manipulated again at state M′ 505and finally released at state R 506. The process may then be repeated tograsp (state G 501), manipulate (state M 502), energetically seal (stateE 503), cut (state K 504), re-manipulate (state M′ 505), and/or release(state R 506) another targeted tissue area.

The embodiments of the devices described herein may be introduced insidea patient using minimally invasive or open surgical techniques. In someinstances it may be advantageous to introduce the devices inside thepatient using a combination of minimally invasive and open surgicaltechniques. Minimally invasive techniques may provide more accurate andeffective access to the treatment region for diagnostic and treatmentprocedures. To reach internal treatment regions within the patient, thedevices described herein may be inserted laparoscopically, such as in amultiple site laparoscopy, a single site laparoscopy, or a singleincision laparoscopic surgery, for example. Further, the devicesdescribed here may be used in a single port access procedure, forexample. Additionally or alternatively, the devices described herein maybe inserted through natural openings of the body such as the mouth,anus, and/or vagina, for example. Minimally invasive proceduresperformed by the introduction of various medical devices into thepatient through a natural opening of the patient are known in the art asNOTES™ procedures. Some portions of the devices may be introduced to thetissue treatment region percutaneously or throughsmall—keyhole—incisions.

Endoscopic minimally invasive surgical and diagnostic medical proceduresare used to evaluate and treat internal organs by inserting a small tubeinto the body. The endoscope may have a rigid or a flexible tube. Aflexible endoscope may be introduced either through a natural bodyopening (e.g., mouth, anus, and/or vagina) or via a trocar through arelatively small—keyhole—incision (usually 0.5-1.5 cm). The endoscopecan be used to observe surface conditions of internal organs, includingabnormal or diseased tissue such as lesions and other surface conditionsand capture images for visual inspection and photography. The endoscopemay be adapted and configured with working channels for introducingmedical instruments to the treatment region for taking biopsies,retrieving foreign objects, and/or performing surgical procedures.

The devices disclosed herein may be designed to be disposed of after asingle use, or they may be designed to be used multiple times. In eithercase, however, the device may be reconditioned for reuse after at leastone use. Reconditioning may include a combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicemay be disassembled, and any number of particular pieces or parts of thedevice may be selectively replaced or removed in any combination. Uponcleaning and/or replacement of particular parts, the device may bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Those ofordinary skill in the art will appreciate that the reconditioning of adevice may utilize a variety of different techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of thisapplication.

Preferably, the various embodiments of the devices described herein willbe processed before surgery. First, a new or used instrument is obtainedand if necessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK® bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility. Other sterilization techniques can be done by anynumber of ways known to those skilled in the art including beta or gammaradiation, ethylene oxide, and/or steam.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.For example, different types of end effectors may be employed. Also,where materials are disclosed for certain components, other materialsmay be used. The foregoing description and following claims are intendedto cover all such modification and variations.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

1-20. (canceled)
 21. An electrosurgical instrument, comprising: an endeffector, comprising: a first jaw comprising a first electrode; and asecond jaw comprising a second electrode, wherein the first jaw ismovable relative to the second jaw between an open configuration and aclosed configuration; a closure member movably positioned relative tothe first jaw and the second jaw, wherein the closure member is movablebetween a proximal position and a distal position during a closurestroke, and wherein the closure member is configured to move the firstjaw toward the closed configuration during the closure stroke; a cuttingmember movably positioned relative to the first jaw and the second jaw,wherein the cutting member is configured to translate between the firstelectrode and the second electrode during a cutting stroke, and whereinthe cutting member is configured to move relative to the closure memberduring the cutting stroke; and a handle comprising a trigger and anactuator, wherein the actuator is operably engagable with the trigger,and wherein an actuation of the actuator is configured to energize thefirst electrode and the second electrode.
 22. The electrosurgicalinstrument of claim 21, wherein a first channel is defined in the firstjaw, and wherein the closure member and the cutting member are movablypositioned within the first channel.
 23. The electrosurgical instrumentof claim 22, wherein a second channel is defined in the second jaw, andwherein the cutting member is movably positioned within the secondchannel.
 24. The electrosurgical instrument of claim 23, wherein theclosure member is configured to pivot the first jaw toward the secondjaw during the closure stroke.
 25. The electrosurgical instrument ofclaim 21, wherein the trigger is operably coupled to the closure member.26. The electrosurgical instrument of claim 21, wherein the trigger isoperably coupled to the cutting member.
 27. The electrosurgicalinstrument of claim 21, wherein the trigger is selectively coupled tothe closure member and the cutting member.
 28. An electrosurgicalinstrument, comprising: an end effector, comprising: a first jawcomprising a first electrode; and a second jaw comprising a secondelectrode, wherein the first jaw is movable relative to the second jawbetween an open configuration and a closed configuration; a closuremember movably positioned relative to the first jaw and the second jaw,wherein the closure member is configured to move the first jaw towardthe closed configuration during a closure stroke; a cutting membermovably positioned relative to the first jaw and the second jaw, whereinthe cutting member is configured to move between the first electrode andthe second electrode during a cutting stroke, and wherein the cuttingmember and the closure member are selectively movable such that thecutting stroke is independent of the closure stroke; and a handlecomprising an actuator, wherein the actuator is selectively coupled tothe cutting member, and wherein movement of the actuator within a rangeof positions is configured to energize the first electrode and thesecond electrode.
 29. The electrosurgical instrument of claim 28,wherein the actuator is further configured to initiate the cuttingstroke when the actuator is coupled to the cutting member and movedwithin the range of motion.
 30. The electrosurgical instrument of claim29, wherein the cutting member comprises a cutting edge configured tomove between a proximal position and a distal position during thecutting stroke, and wherein the proximal position is proximal to thefirst electrode and the second electrode.
 31. The electrosurgicalinstrument of claim 30, wherein the cutting edge is configured to movepast the first electrode and the second electrode after the firstelectrode and the second electrode have been energized.
 32. Theelectrosurgical instrument of claim 28, wherein a first channel isdefined in the first jaw, and wherein the closure member and the cuttingmember are movably positioned within the first channel.
 33. Theelectrosurgical instrument of claim 32, wherein a second channel isdefined in the second jaw, and wherein the cutting member is movablypositioned within the second channel.
 34. The electrosurgical instrumentof claim 28, wherein the handle further comprises a haptic feedbackgenerator.
 35. An electrosurgical instrument, comprising: an endeffector, comprising: a first jaw comprising a first electrode; and asecond jaw comprising a second electrode, wherein the first jaw ismovable relative to the second jaw between an open configuration and aclosed configuration; a closure member movably positioned relative tothe first jaw and the second jaw, wherein the closure member is movablebetween a proximal position and a distal position during a closurestroke, and wherein the closure member is configured to move the firstjaw toward the closed configuration during the closure stroke; a cuttingmember movably positioned relative to the first jaw and the second jaw,wherein the cutting member is configured to move along an axis betweenthe first electrode and the second electrode during a cutting stroke,and wherein the cutting member and the closure member are selectivelymovable such that the cutting stroke is independent of the closurestroke; a handle comprising a trigger and an actuator, wherein theactuator is operably engagable with the trigger and in signalcommunication with the first electrode and the second electrode, andwherein an actuation of the actuator is configured to energize the firstelectrode and the second electrode.
 36. The electrosurgical instrumentof claim 35, wherein a first channel is defined in the first jaw, andwherein the closure member and the cutting member are movably positionedwithin the first channel.
 37. The electrosurgical instrument of claim35, further comprising a controller in signal communication with theactuator, the first electrode, and the second electrode.
 38. Theelectrosurgical instrument of claim 35, wherein the handle furthercomprises a haptic feedback generator.
 39. The electrosurgicalinstrument of claim 38, wherein the haptic feedback generator comprisesa rack and pinion.
 40. The electrosurgical instrument of claim 39,wherein the haptic feedback generator is coupled to the cutting memberand is configured to generate feedback based on the position of thecutting member relative to the first electrode and the second electrode.